Amyloid tumor of the breast

Abstract

Background Amyloid tumor of the breast is a rare disease, which was first reported in 1973. To date, only six cases have been reported in Japan. Case presentation A 45-year-old woman who had a medical history of Sjogren’s syndrome presented with a lump of 3 cm in diameter on the outer side of the right breast. Mammography showed no abnormality. Ultrasonography showed a well-defined and rough hypoechoic mass of 32 mm in diameter at the site of the lump. With suspicion of breast cancer, an ultrasound-guided vacuum-assisted breast biopsy was performed. For pathological diagnosis, hematoxylin and eosin staining showed deposits of nonstructural substances in the interstitium. The specimen stained red with Congo red staining and showed green birefringence under a polarizing microscope. Thus, the mass was diagnosed as an amyloid tumor. Since the patient had Sjogren’s syndrome, it was considered a breast finding of autoimmune disease. We considered further therapy to be unnecessary, and annual follow-up was recommended. Conclusions We diagnosed the mass as an amyloid tumor by an ultrasound-guided vacuum-assisted breast biopsy without resection. The patient had no systemic symptoms suspected systemic amyloidosis, and we diagnosed localized amyloidosis. An amyloid tumor of the breast may show findings suggestive of breast cancer. Pathological diagnosis before surgery is important to avoid excessive invasion. If deposits of nonstructural substances are observed by hematoxylin and eosin staining, Congo red staining should be added.

Accumulation of Innate Amyloid Beta Peptide in Glioblastoma Tumors

“…Different carcinomas have amyloid stroma [54,55], and odontogenic tumors are positive for thioflavin T and Congo Red staining and are also immunopositive for the enamel matrix protein ameloblastin [56,57,58]. Similarly, amyloid was reported in breast cancer tumors but was determined to be a localized amyloid light chain (AL) type (primary amyloidosis caused by ImG light-chain β-sheeting) [59,60]. Localized AL type amyloidosis was also found in myeloma (plasma cell) tumors as well as in kidneys and early-stage non-small-cell lung adenocarcinomas [61].…”

Accumulation of amyloid beta in human glioblastomas

“…For example, multiple myeloma, as well as malignant lymphoproliferative diseases, such as chronic lymphocytic leukemia, hairy cell leukemia, Hodgkin lymphoma and Waldenstrom's disease, is associated with the hypersecretion of Bence Jones [free immunoglobulin (Ig) light chain] protein, generating a particular form of systemic amyloid lightchain (AL) amyloidosis [1][2][3][4]. Unlike systemic amyloidosis, breast cancer exhibits localized light-chain amyloidosis, with amyloid bodies limited to the inside of the tumor [5,6]. Many carcinomas have stroma containing AL-type amyloid [7,8].…”

Localized primary breast amyloidosis and 1-year changes in imaging: A case report

“…Amyloidosis is an uncommon disorder characterized by extracellular deposition of amorphous and insoluble proteins in an abnormal fibrillary configuration. It is divided into systemic amyloidosis, in which amyloid deposits form in organs throughout the body, and localized amyloidosis, which is limited to an individual organ [1] . Systemic amyloidosis causes a variety of symptoms, such as fatigue, weight loss, anemia, cardiac symptoms (congestive heart failure, arrhythmia), renal symptoms (nephrotic syndrome, kidney failure), gastrointestinal symptoms (malabsorption syndrome, macroglossia, hepatomegaly, splenomegaly), neurologic symptoms (polyneuropathy, carpal tunnel syndrome, orthostatic hypotension, constipation, diarrhea, dysuria), and bleeding [1] .…”

“…Systemic amyloidosis causes a variety of symptoms, such as fatigue, weight loss, anemia, cardiac symptoms (congestive heart failure, arrhythmia), renal symptoms (nephrotic syndrome, kidney failure), gastrointestinal symptoms (malabsorption syndrome, macroglossia, hepatomegaly, splenomegaly), neurologic symptoms (polyneuropathy, carpal tunnel syndrome, orthostatic hypotension, constipation, diarrhea, dysuria), and bleeding [1] . The examinations used to check for systemic amyloidosis include electrocardiography, echocardiography, blood analysis (renal dysfunction, M protein, free light chain, autoimmune antibody, and chronic inflammatory findings), urine analysis (Bence-Jones protein), nerve conduction test, bone marrow biopsy, and biopsy of sites suspected of amyloid deposition [1] . Despite the various morphologic tissue manifestations, staining for amyloid protein with Congo red reveals a characteristic apple-green birefringence under polarized light microscopy [1] .…”

“…The examinations used to check for systemic amyloidosis include electrocardiography, echocardiography, blood analysis (renal dysfunction, M protein, free light chain, autoimmune antibody, and chronic inflammatory findings), urine analysis (Bence-Jones protein), nerve conduction test, bone marrow biopsy, and biopsy of sites suspected of amyloid deposition [1] . Despite the various morphologic tissue manifestations, staining for amyloid protein with Congo red reveals a characteristic apple-green birefringence under polarized light microscopy [1] . The precise etiology and pathogenesis of amyloidosis are unknown.…”